撰文丨王聪 编辑丨王多鱼 该研究开展了通过腹腔动脉和肝动脉的 血管内去神经术 （EDN） 治疗血糖控制不佳的 2 型糖尿病 （T2D） 患者的临床试验，结果显示，该方法安全性良好，在 2 型糖尿病患者的血糖控制方面取得了令人鼓舞的结果，糖化血红蛋白 （HbA1c） 和肝功能均得到改善。 2 型糖尿病 （T2D） 的全球患病率正在上升，2021 年有 5.29 亿人患病，预计到 2050 年将超过 13 亿，这一增长凸显了 2 型糖尿病日益加重的公共卫生负 担。 在过去的几十年里，人们开发并优化了多种药物疗法来控制高血糖，包括近期取得进展的 GLP-1 受体激动剂 （例如司美格鲁肽） 。尽管已有多种安全有效的药 物疗法可供选择，但仍有相当一部分患者血糖控制不佳。 药物治疗策略未能充分控制血糖，很大程度上归因于临床惯性以及患者对药物治疗的不依从和不坚持。此外，2 型糖尿病的渐进性往往需要多种药物治疗，这进一 步增加了治疗依从性的难度，并降低了长期治疗效果。这些挑战凸显了当前治疗策略的局限性，以及迫切需要开发出能够独立于患者每日依从性而提供持久血糖 控制的替代方法。 2025 年 11 月 13 日，东南大学附属中 ...

中新网广州11月14日电 (记者 蔡敏婕)"糖尿病视网膜病变('糖网')早期几乎没有症状，很多患者到出 现'看东西模糊、有黑影遮挡、看东西变形'等问题，才前去就医，往往此时视网膜已经发生不可逆的损 伤。"深圳普瑞星耀眼科医院副院长刘万丽表示，糖尿病患者首次确诊以后，务必检查眼底。如果已经 有糖网，需要3-6个月检查一次。 今年11月14日是第19个联合国糖尿病日。广州普瑞眼科医院院长沙翔垠表示，约三分之一的糖尿病人会 并发糖网。此外，糖尿病在眼部的并发症还有白内障、新生血管性青光眼等。 "糖网早期的微血管瘤或血管渗漏点，在视网膜周边部位，不影响中心视力，所以容易被忽视。直到发 展至黄斑区，才有明显症状。"广州普瑞眼科医院眼底外科主任黄新华解释，黄斑区是视网膜视力最敏 锐的区域，约承担我们90%的视力。 值得注意的是，糖网并不是老年人的"专利"。随着糖尿病发病的年轻化，有些中青年人也得糖网，而且 病情进展迅速。广州番禺普瑞眼科医院副院长马海智表示，年轻人新陈代谢快，增殖能力强，因此糖网 病情进展也比老年人更快，更要定期复查，发现问题才能及时处理。 "糖网患者最重要的是，要严格控制血糖。血糖控制好了，可以减少血管 ...

Core Viewpoint - The belief that a vegetarian diet alone can effectively control blood sugar levels is misleading, as blood sugar management depends on a balanced overall diet rather than simply avoiding animal products [2][4][23]. Dietary Structure - Effective blood sugar control is influenced by the overall dietary structure, including the types of carbohydrates consumed and their glycemic index (GI) and glycemic load (GL) [5][7]. - High-GI foods (GI > 70) can cause rapid increases in blood sugar, while low-GI foods (GI ≤ 55) help maintain stable blood sugar levels [5][6]. Misleading Vegetarian Choices - Certain starchy vegetables (e.g., potatoes, yams) and heavily processed vegetarian dishes (high in sugar and oil) can lead to significant blood sugar spikes if consumed in excess [9][11]. - A diet high in unhealthy vegetarian options can increase the risk of diabetes, contrary to the belief that vegetarianism is inherently healthy [12][13]. Nutritional Quality - The quality of food is more important than the "meat vs. vegetarian" label; unhealthy vegetarian diets can lead to nutrient deficiencies and health risks [12][15]. - Key nutrients such as protein, vitamin B12, iron, zinc, and omega-3 fatty acids may be lacking in poorly planned vegetarian diets, affecting overall health and blood sugar stability [15]. Healthy Eating Strategies - A balanced approach to eating, including a mix of whole grains, vegetables, and quality proteins, is essential for effective blood sugar management [17][18]. - Recommended eating patterns include prioritizing vegetables and proteins before carbohydrates, using healthy cooking methods, and incorporating natural spices for flavor [19][20][22]. Conclusion - Instead of focusing solely on whether to eat meat or not, individuals should concentrate on achieving a balanced diet, making informed food choices, and employing healthy cooking techniques to maintain stable blood sugar levels [24][25].

Core Viewpoint - The article highlights the increasing prevalence of diabetes in China, emphasizing the health risks associated with high blood sugar levels and the importance of monitoring and controlling blood sugar to prevent complications. Group 1: Diabetes Prevalence and Risks - Diabetes has become the third most significant chronic non-communicable disease affecting public health in China, with the prevalence continuously rising [1] - High blood sugar levels can lead to various health issues, often without noticeable symptoms, causing ongoing damage to the body [1] Group 2: Symptoms Indicating High Blood Sugar - Changes in the legs and feet can signal uncontrolled blood sugar levels, as small blood vessels are often damaged first, leading to noticeable symptoms in these areas [3] - Common symptoms of high blood sugar include slow wound healing, itching, numbness in legs and feet, appearance of "sugar spots," and dry skin [6][7][8][9][10][11] Group 3: Blood Sugar Control Strategies - Effective blood sugar management involves not only lowering blood sugar levels but also maintaining stability to prevent complications such as heart attacks and kidney damage [13] - Recommended strategies for controlling blood sugar include increasing whole grains in the diet, eating harder foods, slowing down eating speed, adjusting the order of food intake, and being mindful of the glycemic index (GI) and glycemic load (GL) of fruits [15][16][17][18][19][20][21] - Regular exercise is also emphasized as a crucial component for lowering blood sugar and improving insulin response [22]

Core Viewpoint - The article discusses the significant weight loss effects of oral semaglutide in overweight or obese patients without diabetes, highlighting the results of the OASIS 1 study and the PIONEER PLUS study, which demonstrate its efficacy and safety in weight management and blood sugar control [6][20]. Group 1: OASIS 1 Study Findings - The OASIS 1 study showed that daily oral administration of 50mg semaglutide led to an average weight loss of 15.1% after 68 weeks, with 85% of participants achieving clinically meaningful weight loss (≥5%) [6][9]. - The study included 667 adults with a BMI of ≥30kg/m² or ≥27kg/m² with weight-related complications, randomly assigned to either the semaglutide group or a placebo group [6][8]. - The treatment demonstrated a significant difference in weight loss compared to the placebo group, which only saw a 2.4% reduction (p<0.0001) [9][11]. Group 2: PIONEER PLUS Study Insights - The PIONEER PLUS study focused on the effects of high-dose oral semaglutide on blood sugar control in patients with type 2 diabetes and obesity, showing that higher doses (25mg or 50mg) resulted in better glycemic control and weight loss compared to the standard 14mg dose [20]. - Results indicated that the 50mg dose group achieved an average HbA1c reduction of 2.0%, with 63% of patients reaching the target HbA1c <7.0% [18][20]. - The study also reported that patients in the higher dose groups had a higher percentage of weight loss exceeding 5% or 10% compared to the standard dose group [18][20]. Group 3: Safety and Tolerability - The overall tolerability of semaglutide treatment was good, with 80% of patients reporting gastrointestinal adverse effects, mostly mild to moderate [13][15]. - The incidence of any adverse events was higher in the semaglutide group (91.9%) compared to the placebo group (85.6%), but serious adverse events were relatively low [15]. - Common adverse events included nausea (51.8% in the semaglutide group) and gastrointestinal disorders, but no fatal events were reported [15].

Group 1 - The core idea emphasizes the health benefits of walking after meals, particularly in reducing blood sugar and triglyceride levels [4][6][9] - Research indicates that sitting after meals can lead to a significant increase in postprandial blood sugar, with sitting causing a 2.75 times greater increase compared to walking [4] - Engaging in light physical activity, such as walking, can significantly lower post-meal triglyceride levels, with reductions of about one-third observed in studies [7] Group 2 - Walking after meals aids digestion and can help with weight management, as it promotes food movement through the digestive system and alleviates feelings of fullness [9] - For individuals aged 65 and older, specific considerations for walking include choosing appropriate routes, maintaining stable walking pace, being mindful of weather conditions, and planning walking intensity [10][11][12][13][14]

Core Viewpoint - Poor glycemic control in children with type 1 diabetes can lead to a significant reduction in adult height, with potential losses of 2 to 3 centimeters, particularly affecting boys during their growth spurts [5][8][10]. Group 1: Impact of Poor Glycemic Control - A nationwide cohort study from Sweden indicates that children with poor blood sugar control may experience a height reduction of 2 to 3 centimeters in adulthood [5][8]. - The study highlights that for every 1% increase in HbA1c levels, children's final height decreases by 0.3 centimeters, especially during puberty when growth hormone secretion is disrupted [6][10]. Group 2: Gender Differences in Height Impact - Male patients with poor glycemic control (HbA1c > 9.0%) experience an average height reduction of 2.91 centimeters, while female patients see a reduction of 1.83 centimeters [10]. - The timing of diabetes onset plays a crucial role; boys are affected regardless of when they develop diabetes, while girls primarily face height loss if diagnosed before puberty [12][14]. Group 3: Recommendations for Height Preservation - Early intervention is critical; establishing a strict blood sugar monitoring system from diagnosis is essential, particularly during the peak growth period of puberty [14][15]. - A balanced diet that reduces high-sugar and high-fat foods while increasing fiber, quality protein, and vitamins is recommended to stabilize blood sugar levels [16]. - Regular aerobic exercise can enhance insulin sensitivity and aid in blood sugar control [17]. - Psychological support is important, as chronic illness can lead to emotional stress; parents should monitor their children's emotional well-being and seek professional help if necessary [18].

Core Viewpoint - The article discusses the misconceptions surrounding white rice as a staple food, highlighting that while it has a high glycemic index (GI), its impact on blood sugar levels is influenced by dietary habits and food pairings, particularly in the Chinese context [9][10]. Summary by Sections White Rice and Health - The claim that white rice is the "worst staple food" is prevalent, but scientific evidence shows that its high GI (GI > 80) can lead to rapid blood sugar spikes, which is concerning for those managing diabetes [9]. - A meta-analysis from 2022 indicates that consuming over 300 grams of rice daily can increase the risk of type 2 diabetes by 13% for every additional 158 grams, though this does not fully apply to the Chinese population due to different dietary practices [9]. Nutritional Role of Rice - Rice serves as a crucial energy source, and completely eliminating it from the diet may lead to health issues such as metabolic disorders and cognitive decline [10]. - Recommendations include moderate consumption, avoiding overcooking, and pairing rice with whole grains and vegetables to stabilize post-meal blood sugar levels [10]. Dietary Differences: Japan vs. China - Japan has a lower diabetes prevalence despite rice being a staple, attributed to four key dietary differences: rice temperature, portion sizes, cooking methods, and the use of vinegar [11][12]. - Japanese people often consume cooled rice, which forms resistant starch that slows glucose absorption, while Chinese diets typically feature hot rice in larger portions [11]. - Cooking methods in Japan are generally healthier, focusing on lighter preparations compared to the heavier, oil-rich Chinese cooking styles [12]. Hidden High-GI Foods - The article warns about "hidden glycemic bombs" that are often perceived as healthy but can significantly impact blood sugar levels, such as flavored milk products and freeze-dried vegetables that may contain added sugars [13][14]. - Fruits like dragon fruit and certain snacks like soda crackers also have high sugar content and glycemic indices, which can be misleading [14]. - It emphasizes that moderate rice consumption, when paired with other foods, is safer than opting for seemingly healthy alternatives that are actually high in sugar [14].

Core Insights - The number of diabetes patients in China has reached 233 million, accounting for one-fourth of the global diabetes population, with a 163% increase since 2005 [2][6]. Group 1: Prevalence and Demographics - The prevalence of diabetes in China is approximately 1 in every 6 individuals [2]. - Male diabetes prevalence is consistently higher than that of females, influenced by smoking, obesity, and various socio-cultural and biological factors [3]. - The highest diabetes prevalence is found in North China, followed by Northeast and East China, with lower rates in South, Southwest, and Northwest regions [6]. Group 2: Regional Distribution - Beijing has the highest diabetes prevalence rate at 28.45%, followed by Tianjin at 25.78% and Shanghai at 22.04% [5]. - Regional differences in diabetes prevalence are closely related to economic development, dietary habits, and lifestyle choices [6]. Group 3: Skin Manifestations of Diabetes - High blood sugar levels can lead to various skin conditions, including acanthosis nigricans, which is common in pre-diabetic and diabetic patients [9]. - Other skin issues include dry skin, skin tags, and reduced sensation in the feet, which are serious complications of diabetes [13][10][11]. Group 4: Dietary Recommendations - To manage blood sugar levels, it is essential to control carbohydrate intake and maintain stable blood sugar levels through a balanced diet [25]. - Recommended dietary components include whole grains, vegetables, fruits, and protein sources, with specific guidelines on portion sizes [26][28]. - Cooking methods should favor steaming and boiling over frying or heavy seasoning to support blood sugar stability [29].

Core Insights - The article emphasizes that not all whole grains are effective in controlling blood sugar levels, with some "pseudo whole grains" having a faster glycemic response than refined grains like white rice and flour [2][6]. Group 1: Types of Grains - Certain sticky grains, such as glutinous millet and black glutinous rice, have a higher glycemic index and can raise blood sugar levels quickly [3][6]. - Whole grains like oats and red beans contain more resistant starch, which has a lower impact on blood sugar due to their tightly packed structure [5]. Group 2: Consumption Methods - The method of consuming whole grains can significantly affect their glycemic index; grinding grains into powder and mixing them with water can increase their glycemic response [9][11]. - For individuals needing to control blood sugar, it is advisable to choose whole grains that maintain a low glycemic index even after processing, such as green beans and lentils [11]. Group 3: Dietary Recommendations - It is recommended to combine whole grains with protein and fiber-rich foods, such as milk and vegetables, to mitigate blood sugar spikes [8][13]. - A balanced intake of whole and refined grains is suggested, ideally maintaining a ratio of 1:1 or 2:1, depending on individual digestive health [14].